Trying To Beat Urine Tests Not So Easy, Specialist Says

To avoid a positive drug test, some people have had catheters, preloaded with freeze-dried drug-free urine specimens, inserted into their urinary tracts a laboratory specialist said yesterday.

Dr. Richard Earley, manager of toxicologic services for SmithKline Bioscience Laboratory, said people have devised numerous schemes and excuses to hide illegal drug use, but the laboratory testing programs today are virtually fool-proof.

"I don't want to say our testing is absolutely perfect," he said, "but the processes we go through now have virtually ruled out issues from 15 years ago."

Employees and doctors who had gone to the extreme of using catheters, for instance, were discovered when traces of blood from the insertion of the tubes showed up in the urine samples.

Earley, who said he has 20 years of experience in drug testing, was the guest speaker yesterday at a seminar for administrators and human relations directors at Sacred Heart Hospital.

About 60 people attended, including state police, lawyers and manufacturers of drug testing equipment.

Several area hospitals have some form of drug-testing policy in place and Allentown Osteopathic Medical Center recently instituted a program to test current as well as prospective employees. However, a spokesman for Sacred Heart said the hospital still saw no need to implement one itself.

Dr. Stephen L. Klincewicz, Sacred Heart's new director for occupational and environmental medicine, invited Earley to speak to help the community understand what he called the "controversial and confusing" issues of drug testing.

Equipment used to analyze urine samples today can detect "nanograms" -- or one billionth of a gram -- of amphetamines, opiates and other drugs, according to Earley.

With such sophisticated computerized tests, certified laboratory scientists can tell the difference between an employee who has a passion for bagels with poppy seeds and an employee addicted to heroin.

"Chemically, there is no difference from the morphine one sees from poppy seeds and the morphine one sees from injecting heroin," Earley said. But the difference should show up in the quantities of morphine in the urine.

Using much the same argument, Earley said, drug testing programs have ruled out "passive" inhalation as a legitimate reason for an employee to test positive for marijuana.

"Some studies had shown that if you packed enough people into a Volkswagen and enough were smoking marijuana that the non-smoker would test positive from inhaling the smoke around him," he said. "But we quickly realized that was not the normal workplace or social situation."

Mandatory federal guidelines, established in April 1988, demand stringent criteria for laboratory testing, including the certification of personnel and continuing checks for proficiency.

Since then, many of the federal agencies have developed their own regulations, and many private employers have begun testing voluntarily for more drugs than the federal government requires of its own workers.

Earley used an overhead projection to help describe the mandatory federal drug-testing process, from urine collection to the reporting of the results.

Employees who try hiring someone to stand in for them for the physical can be caught at the collection stage, because they fail to produce appropriate identification or verification. In some cases, especially if the prospective employee has a prior history of drug abuse, a monitor may be used to be sure the person is actually supplying his or her own urine.

People who attempt to dilute their urine with water or by taking diuretics might make it through the collection phase, Earley said, but they would fail a screening for levels of creatinine and chloride -- normal components of urine.

Before confirming the presence of any particular drug, SmithKline screens the urine sample for several different chemicals. Only those that appear to be positive during the screening are subjected to further tests for confirmation.

Confirmation is dependent on the substance passing 12 separate chemical events, such as pH or acidity levels. According to Earley, "Failure to pass any one of the 12 points means the sample is not determined to be positive."

Certified scientists review any positive findings and release them to a physician, who is called a "medical review officer." The physician determines if the presence of the drug is due to substance abuse or something else.

A positive test for opiates, for instance, may show up because the person tested was taking a pain reliever with codeine.

No name accompanies the urine or blood samples tested, Earley said. Instead, the specimens are given employee identification numbers and bar codes.

When a physician determines that there is evidence of drug abuse, the employee is given an opportunity to discuss the results before the employer is informed.

"That should be included in any substance abuse program," Earley advised.

SmithKline, which claims to have the single largest network of clinical laboratories in the United States and Canada, has four of the 38 U.S. laboratories licensed to perform drug testing under the federal requirements.